Radiation Therapy Alone for Imaging-Defined Meningiomas

Korah, M.P.; Nowlan, Adam; Johnstone, Peter A.S.; Crocker, Ian

doi:10.1016/j.ijrobp.2009.01.066

Cited by 48 publications

(34 citation statements)

References 26 publications

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“…This is particularly important in recent years, as treatment such as stereotactic radiosurgery is being used to treat meningioma based on radiological diagnosis alone, without histopathological correlation. 14,15 This makes awareness of true meningioma mimics important, as histopathological evaluation is necessary for diagnosis and treatment. While calvarial hyperostosis is occasionally reported to occur with dural NHL, this is the first report of confirmed calvarial hyperostosis in systemic HL presenting as an extra-axial mass.…”

Section: Resultsmentioning

confidence: 99%

Extra-axial Hodgkin’s lymphoma with bony hyperostosis mimicking meningioma

Paiva¹,

King²,

Chandra³

2011

Journal of Clinical Neuroscience

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Section: Resultsmentioning

confidence: 99%

Extra-axial Hodgkin’s lymphoma with bony hyperostosis mimicking meningioma

Paiva¹,

King²,

Chandra³

2011

Journal of Clinical Neuroscience

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“…Radiotherapy has therefore been used as both an adjunct to incomplete surgical resection as well as a primary treatment for meningiomas when surgery carries significant risk. Specifically, the results of stereotactic radiosurgery (SRS) as both a primary treatment and adjunctive therapy for benign meningiomas have been extensively reported in the literature [9,[13][14][15][16][17][18]. The results of multiple studies demonstrate 5 and 10-year tumor control rates similar to gross-total surgical resection, especially for skull base lesions [13,19,20].…”

Section: Introductionmentioning

confidence: 99%

Stereotactic radiosurgery for benign meningiomas

et al. 2011

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Meningiomas are the second most common primary tumor of the brain. Surgical resection is the preferred treatment for easily accessible tumors that can be safely removed. However, many tumors arise deep within the skull base making complete surgical resection difficult or impossible. Stereotactic radiosurgery is a highly effective alternative to surgical resection that has been used as a primary therapy for benign meningiomas as well as an adjuvant treatment for residual or recurrent tumors. The 5-year tumor control rates for stereotactic radiosurgery are equivalent to gross-total resection with lower morbidity than surgery, especially for skull base lesions. Additionally, adjuvant treatment of subtotally resected tumors results in tumor control rates equivalent to gross-total resection. Stereotactic radiosurgery has been used extensively for the treatment of small and medium sized skull base meningiomas. This technique has also been applied to large meningiomas and superficial tumors such as convexity and parasagittal meningiomas. However, multiple studies demonstrate that tumor control is decreased for superficial lesions and with increasing tumor size. In addition, radiation toxicity increases with increasing tumor size and superficial location. Based on a thorough review of the literature, stereotactic radiosurgery should be considered the primary treatment for skull base meningiomas with high surgical risk and in cases of superficial meningiomas where surgery is contraindicated.

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“…18 Consequently, SRS has emerged as a suitable primary/adjuvant treatment modality for the management of meningiomas, demonstrating control rates ranging from 86% to 99%. 12,17,18,20,21,32,33 While SRS minimizes many of the morbidities associated with aggressive resection, delayed adverse outcomes such as radiation necrosis, cranial nerve neuropathies, occlusion of the venous structures, hydrocephalus, and edema are possible; the occurrence of these complications is approximately 10% in the reported literature, with variability depending on the cohorts of analyzed patients. 1,31,37,43,44,46,50 Post-SRS edema has been reported as an adverse effect/complication, which can result in neurological symptoms.…”

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confidence: 99%

Predictors of response to Gamma Knife radiosurgery for intracranial meningiomas

Mansouri

Larjani

Klironomos

et al. 2015

JNS

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M eningioMas are the most common primary intracranial nonglial neoplasms in adults. 34 When feasible, the ideal management of meningiomas is complete resection of the tumor and associated dura mater, with the goal of minimizing further neurological morbidity for the patient. 28 However, not all meningiomas are amenable to gross-total resection (e.g., extensive involvement of skull base structures or invasion into the venous sinuses or other neurovascular structures), and alternative complementary treatment strategies are necessary. 4,27,40 abbreviatioNs ARE = adverse radiation event; CI RTOG = Radiation Therapy Oncology Group Conformity Index; RT = radiotherapy; SGR = specific growth rate; SRS = stereotactic radiosurgery; TVR = treatment volume ratio. obJect In this paper, the authors' aim was to determine short-term volumetric and diametric tumor growth and identify clinical, radiological, and dosimetric predictors of adverse radiation events (AREs) following stereotactic radiosurgery (SRS) for intracranial WHO Grade I meningiomas. methods This is a retrospective review of all WHO Grade I meningiomas that were treated with SRS (primary or adjuvant) between December 2005 and June 2012 at the University Health Network. Seventy-five patients had at least 24 months of both clinical and radiological follow-up and were, therefore, included in this study. Tumor growth was defined as any volumetric or diametric change greater than 10% per year. Any variation less than +10% was considered growth stability. Volumetric measurements were made using T1-weighted gadolinium-enhanced 3-T MRI scans and ITK-SNAP software. Tumor growth rates were calculated using the specific growth rate (SGR). Univariate statistics were used to identify predictors of post-SRS AREs. All statistical analyses were performed using IBM SPSS. results Women accounted for 69.3% of patients, and the mean treatment age was 58.6 years. Median follow-up was 36.2 months. Twenty-one (28%) patients had undergone prior resection. Two (3%) patients required salvage surgical intervention following SRS. The majority of the lesions (56%) were skull base tumors. Median tumor volume and diameter were 5.2 cm 3 and 27.5 mm, respectively. The absence of tumor growth was observed in 39 cases (52%) based on the volumetric measurements, while the absence of tumor growth was observed in 69 cases (92%) based on the diametric measurements. Twenty-six patients (34.6%) experienced new-onset AREs, including headache (17.3%), cranial neuropathy (10.6%), speech impairment (2.7%), tremors (2.7%), and ataxia (1.3%). Fourteen patients (18.7%) experienced new-onset edema, and 4 of these patients were symptomatic. A lower conformity index (1.24 vs 1.4) was significantly associated with the development of edema (p < 0.001 power > 0.8). Patients with meningiomas that had growth rates of more than 10% per year were more likely to experience long-term headaches after SRS (p = 0.022). coNclusioNs Volume-based reporting of SRS outcomes for meningiomas may be a more accurate method given the ...

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Radiation Therapy Alone for Imaging-Defined Meningiomas

Cited by 48 publications

References 26 publications

Extra-axial Hodgkin’s lymphoma with bony hyperostosis mimicking meningioma

Extra-axial Hodgkin’s lymphoma with bony hyperostosis mimicking meningioma

Stereotactic radiosurgery for benign meningiomas

Predictors of response to Gamma Knife radiosurgery for intracranial meningiomas

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